1. Field of the Invention
This invention relates to a method and apparatus for joining together two or more hollow body lumens, and more particularly, to a method and apparatus for anastomosis of body lumens without the use of sutures, staples or clamps.
2. Description of Related Art
There are many surgical procedures requiring the connection of vessels, hollow organs and other structures, collectively body lumens. Coronary surgery is an example of such a procedure. In certain heart operations where bypass surgery is performed, sections of a coronary artery to the heart may either by completely replaced, or actually bypassed during heart bypass surgery. While some of these arteries are large, and more easily manipulated by the surgeon, other body lumens are smaller and more difficult to manipulate and hold in position while joining ends thereof after a transectional operation. These procedures typically use devices that employ staples, clamps or sutures.
More specifically to surgical procedures involving the prostate, radical retropubic prostatectomy is an established method for the treatment of patients with localized carcinoma of the prostate gland. Additionally, a prostatectomy may be performed for a variety of different medical reasons. Complications include intraoperative hemorrhage, postoperative erectlie impotence, stricture formation as well as possible disruption of the urogenital diaphragm which can render the patient incontinent. Unfortunately, impotence and incontinence are frequent occurrences resulting from many known radical prostatectomy procedures.
Prostatectomy usually involves division of the urethra at the apex of the prostate and removal of the prostate, and the stump of the urethra can retract into the adjacent tissue, the urogenital diaphragm. Two significant challenges to the surgeon are reexposure of the urethra, as well as avoiding nicking the urogenital diaphragm while performing an anastomosis of the urethra to the bladder.
Essentially, the procedures performed to date require that the surgeon grasp the end of the transected urethra and stretched it to the mating end of the urethra at the bladder with one hand, and with the other hand perform delicate suturing with tiny, fine needles. Microsurgery of this nature is highly dependent on the skill of the surgeon. Some are much better at this kind of delicate surgery than others.
A number of different microsurgery solutions, many of which are suitable to a variety of surgical procedures, have been proposed. In U.S. Pat. No. 4,553,543, a plurality of flexible suture needles are held in place in slots in a flared core by a sleeve that extends about the flexible suture needles and the core. The suture needles, and attached threads, penetrate the walls of a body duct, such as a blood vessel, by inserting the flared end of the core into the severed body duct. Needles are then forced to move longitudinally in the slots against the flared end of the core so that they bend outwardly, and are driven through the wall of the duct.
A number of patents have issued relating to anastomosis and tissue ligation, including: U.S. Pat. Nos. 2,897,820; 4,784,139; 4,911,164; and 5,209,725. Patents that directed to urethra and bladder anastomosis include: U.S. Pat. Nos. 4,848,367; 4,873,977; and 5,047,039.
The patents for urethra and bladder anastomosis involve suturing or other non-passive fixation techniques. As previously mentioned, if the urogenital diaphragm is nicked, as can occur with sutures, then the patient may become incontinent. Accordingly, it would be desirable to provide a passive fixation device and method which does not require sutures or other types of invasive treatment. Such an apparatus and method would be useful in a variety of surgical procedures where it is necessary to join two body lumens.